This Is Going to Hurt
When I first read Adam Kay’s book of this title, I laughed until I cried. I knew along the way that there were things I shouldn’t be laughing at. I felt guilty for finding it funny. But I laughed nonetheless. In fact, I laughed a lot. Watching the recent TV adaptation of the book on the BBC, I laughed less. I think partly because the script was less funny than the original writing. But also, perhaps, because seeing the reality of the working environment of the NHS staring me in the face on the screen before my eyes, made it altogether less funny.
If you are not based in the UK, you may not have seen or heard of this series, or perhaps the book. The book was written by Kay, based on his real-life experiences as a junior doctor in the UK National Health Service specialising in obstetrics and gynaecology. It is intended to be funny, for sure. But it also packs a hard punch in the guts as it shines a light on the reality of working in the NHS. I still remember the last paragraphs of the book, in which he spells out his reasons for leaving medicine and appeals to readers and to politicians to remember that doctors are also human beings. It is incredibly moving. Read the book and you will see what I mean.
The issues of wellbeing, mental health, burn out and suicide in the NHS that are documented so poignantly and painfully in Kay’s book and TV series, remind me a lot of those that exist in the humanitarian / aid sector. I know this from my work with clients operating in this sector, including my place on a Board of Advisers for Employee Wellbeing for one humanitarian organisation. Often these systems are simply not fit for purpose. They are not safe for people to work within. They are too broken to look after those that work within them. This is a tragedy — especially perhaps when those working within them are trying so hard to provide care and better life outcomes for others.
Broken and toxic systems, however, are not only the domain of the humanitarian sector and UK health service. I have come across plenty of private sector company cultures that could be described in the same way and that leave those that pass through them, broken, scarred and in need of recovery. The pandemic, as we all know, has raised the profile of wellbeing at work in recent years and we are all now well versed in some of the associated issues, dynamics and arguments. But what has changed? And how do we make progress?
Supporting people to ‘work well’ is part of my work and purpose. This takes different forms but includes facilitating ‘cultures of care’ in organisations, developing leaders who are able and motivated to create environments where their people can thrive, and supporting teams to build purpose and connection as a means of enhancing collective fulfilment and performance. It also includes working with individuals to equip themselves with the mindset and practices needed to take care of themselves.
One of the questions that arises a lot in the work and the conversations that take place in this space, are about where responsibility lies for employee wellbeing. For the most part, I read articles and hear people talk about organisational responsibility and I certainly advocate for this. It is surely indisputable that there is a duty of care on organisations to put in place the infrastructure, leadership and culture that facilitate wellbeing. This has got to be right. But is that where it ends? My view is that it does not and cannot: the individual must be engaged and take responsibility too.
In my coaching work with individuals, I regularly meet people who struggle with saying ‘no’, who struggle with boundaries, who are dependent on their work for their sense of self-worth, who do not know what they need in order to feel well in life or work, never mind how to put in place the practices required. I have worked with plenty of people over the years who are not sufficiently in touch with their feelings to know or express how they really are, and even more who are not comfortable with any degree of vulnerability (doctors I have worked with would feature highly in this group), particularly in the workplace. These people are not unusual. I would say they are the majority. I would have counted myself among them in the past, and sometimes still, today. There is so much more we can all do to take responsibility for our wellbeing, to learn what it is we want and need to thrive in life and in work, and then have the courage to put it into practice.
Please don’t misunderstand me. I am not saying it is all about the individual. Watching ‘This is Going to Hurt’ — and the tragic way the story unfolds — really brought home to me the colossal task of being ‘well’ when working in such a broken system and how much responsibility sits with organisational systems (and governments, of course) to put this right. Let’s do what we can to make that happen.
But let’s also, please, get better at taking care of ourselves.
